Staying Engaged During a Pandemic

Segment Description: Thomas Dilworth, PharmD, pharmacy coordinator, infectious diseases, Aurora St. Luke’s Medical Center, shares tips and resources that can help busy clinicians stay engaged and up to date during the COVID-19 pandemic.

Interview transcript: (modified slightly for readability)

Contagion®: What are your tips for clinicians who are struggling to stay up to date with all the news and published literature about COVID-19 while trying to respond to the pandemic?

Dilworth: Yeah, I think that's a great question for which I probably don't have the best answer. I don't know what the best answer is, but I can tell you what I've been doing. I think for all of us that are involved in this pandemic, it's long days, you go to bed late, you wake up early. I'm frequently up very early in the morning and I would recommend to those who are struggling to find information to find a couple good resources on the internet in frequent them every day. Sign up for table of contents or COVID alerts through organizations or journals that you trust or like to read. I frequently go to The Lancet at least every day looking at new publications. I go to the New England Journal [which] has a really good website and their spin off Journal Watch also has a really good website on COVID-19. CDC is a really good place for up to date information.

There's actually a pharmacy website called ID Stewardship, they cover a lot of ground in infectious disease, pharmacotherapy and antimicrobial stewardship. They have a regularly updated section on all things COVID and I go to that every day, looking for new things. I'd also recommend people review publicly available protocols and guidance. Examples are Massachusetts, General Hospital, University of Nebraska, University of Washington, the University of Wisconsin at Madison. There are others, but go to those websites, look at their protocols, look at their recommendations for infection prevention and triage and PPE.

Another thing I find helpful is just querying medRxiv, which I cited before. That's where scholars can upload manuscripts that have been submitted or will be submitted but have not undergone peer review, and then others can view them. Now there's sort of a catch 22 because when stuff has not been peer reviewed, it hasn't been officially vetted. You have to take it with a grain of salt. Some of the stuff I've seen on medRxiv, unfortunately, is of lower quality and not helpful. But, there's a lot of stuff out there that's been investigated and written by notable authors who have a track record of high-quality publications and contributions to infectious disease science and therapeutics. And that's going to be another good resource that you should probably check at least every day if not every other day, but again, it's not peer reviewed.

Finally, one thing that I check multiple times per day is the Johns Hopkins database that tracks all of the COVID cases throughout the world, as well as mortality. So for example you can hone in on the United States, you can see how many cases we have confirmed. Then you can you can even drill down on state or city. You could you could pick New York City, for example, you can look at those data or wherever it is that you're working. I live in Wisconsin, so I frequently look at the Wisconsin data.

There's also another really a great website that I think is important. This is more from a 30,000-foot view, looking at the social distancing piece of things and how are the efforts we're doing impacting the slope of the curve. It's called Flip the Script and it's a website where they take the Johns Hopkins data, and they plot it out in a logarithmic fashion and also in a linear fashion. It does it by country and by US state. You can also do it normalized by population for country and US state. So it's really nice. I find myself going to that frequently just looking at the United States curve, you know, are we are we tracking with Italy? Are we tracking with Spain? Are we tracking with South Korea? We're not tracking with South Korea, but I can just kind of look at the trajectory of the curve. Then I can do the same thing for Wisconsin.

One other thing I would plug that I think is really informative if people haven't looked at it…this was a medRxiv pre-pub, but it was a group of researchers out of the University of Washington. They did a sobering analysis that was remarkable in both its scope and its clarity. They looked at hospital beds, ICU beds and ventilators, for every US state, and they looked at how the surge was going to roll out to each state. They estimated what the peak search date would be. For Wisconsin, for example, it was April 27. They said, this is how many hospital beds, you'll be short how many ICU beds you'll be short, how many ventilators you'll be short. They also have a companion website where you can visualize your state; it is really informative, and I would encourage people to look to that as well.

So obviously, that's a lot. Maybe you don't have time to do all those things every day. But I would suggest finding 30 to 60 minutes if you can every day to look at some of the stuff and print papers off and try to stay ahead of this. It's unlike anything I've ever seen in my career, just the pace of new information and data. Ut's hard to keep up, so you have to come up with a system that works for you.

>>Watch: Dilworth recaps his webinar presentation on ARBs, ACEIs, and NSAIDs.